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ME-02-127PERMIT APPLICATION FOR MIAMI SHORES VILLAGE 10050 N.E. 2nd Avenue • Miami Shores, Florida 33138.305. 795 -2204 w /VI-16 // — 32ea — 0(4 - /ft Date Job Address Tax Folio Legal Description 44 1 k t / Z Historically Designated: Yes No K 0a70L /. Owner's Address Contracting Co. ssee/Tenet Na 'f ; c* E PA i"41" 4<.4z*. Ceate4aster Permit # Qualifier C./ State # - kJ3_ P3 Municipal # IF THERE IS NO PERMIT PACKAGE ACCESSIBLE ON THE JOB SITE FOR INSPECTORS TO VERIFY, THERE WILL BE NO INSPECTION. RE- INSPECTION FEE IS $50.00 AND MUST BE PAID IN ADVANCE BEFORE CALLING FOR ANOTHER INSPECTION. Permit Type (circle one): BUILDING ELECTRICAL PLUMBING WORK DESCRIPTION: itere 4,944 Signature of owner and/or Condo President FEES: PERM ,51 RADON APPROVED: Zoning Mechanical Square Ft. Estimated Cost (value) A Phone "eV 754-- .j 9 -4 /,/� ti Address Address / 6 # bf)/. / t fr..9ze ss# Phone 3e) g ' Competency # Date Notary as to Contractor or Owner '1 • er My Commission Expires C.C. 6 ( d ) 0 NOTARY Ins. Co. ,3 1 QAJ - At- 7 - WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY (IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ANY ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.) Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for all disciplines. OWNERS AII-IDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Furthermore, I authorize the above named contractor to do the work stated. /0 0, ANYIPLATAtt , ., a d; .11 BOND ROOFING TOTAL DUE • a C 1 # Building Electrical, Ca C ) /*° /' 0 1" Plumbing Structural Engineer ITEM 3ATH TUB UNIT • FEE ITEM , SWITCH OUTLETS UNIT FEE ITEM SPACE HEATERS UNIT FEE 3IDET LIGHT OUTLETS CENTRAL HEATING lISHWASHER RECEPTACLES A/C (WIND) )ISPOSAL SERVICE TEhFCRARY • A/C (CENTRAL). AINKING FOUNTAIN SERVICE SIZE IN MPS DUCT WORK - '.. 1.00R DRAIN SERVICE REPAIR/NETER CHANGE . . REFRIGERATiON : ;REASE TRAP APPLIANCE OUTLETS PROCESS AND PRESS PIPING • „, 'NTERCEPTOR , RANGE TOP :UNDERGROUND TANKS ,.." .::;; AVATORY OVEN ABOVE GROUND TANKS .. - AUNDRY TRAY WATER HEATER U.F. PRESSURE VESSELS.: ' :LOTHES WASHER MOTORS 0- 1 If STEAM BOILERS - HOWER MOTORS OVER 1- 3 HP HOT WATER BOILERS :INK, POT/3 COMP. MOTORS OVER 3- 5 HP MECHANICAL VENThLATitt:I.. :INK, RESIDENCE MOTORS OVER 5- 8 hP . TRANSPORTING ASSEMBOEG INK, SLOP MOTORS OVER 8- 10 HP. - ELEVATORS/MALATORS EMPORARY WATER CLOSET . MOTORS OVER 10- 25 HP - • 'FIRE. SPRINKLER SYSTENS„. '-- RINAL -- . MOTORS OVER 25-100 HP „_. . COOLING TOWERS -.. - ATER CLOSET MOTORS OVER 100 FP VIOLATION NOIRECT WASTES , _ . . -- . . • A/C WINDOW REINSPECTION ATER SUPPLY TO: AIR CONDITIONERS • A/C UNIT - .. -.:-. ' ....., - - STRIP HEATER - . FIRE SPRINKLER ..: - :GENERATORS TRANSFORMERS ' HEATER-NEW INST. - GENERATORS TRANSFORMERS . HEATER,REPLACE --'.-- GENERATORS TRANSFORMERS • LAWN SPRINKLER-WELL SPECIAL PURPOSE SWIMMING POOL • OUTLETS COMMERCIAL WATER SERYICE: : - ' SIGN TUBES :WER CONNECTIONS ' - 'ILITY-SEWER SIGN TRANSFORWRS •- .... . •ILITY-WATER • ' . • SIGN TIME CLOCK - • • FIXTURES PTIC TANK . . . ANTENNA LAY TELEVISION CUTLETS AINFIELD, 4" TILE/RES. -- VIOLATION W & ABANDON SEPTIC TANK . REINSPECTION AKAGE PIT CU. FT. TCH BASIN , ' . . SCHARGE WELL . WESTIC WELL EA DRAIN ,. OF INLET AR WATER HEATER '. lE STANDPIPE X. PIPING • 01 SPRINKLER SYSTEM ;RANGE 'ER SET (GAS) ; PIPING r . ADDENDUM TO BUILDING PERMIT APPLICATION (AN AivocAlioN FORPOILDING PERMIT MUST ACCOMPANY THIS ADDENDUM. IF A MASTER PERMIT HAS B. OBTAINED, THE OWNER'S NOTARIZED SIGNATURE NEED NOT BE PRESENT ON SUBSEQUENT APPLICATIONS.) PLUMBING ELECTRICAL MECHANICAL Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 9/16/2002 Applicant: VA,,e sf� � . Owner: ST 1 �e� 'red JOB ADDRESS: 602 NE 96 Contracto Local Phone: Parcel # 1132060141410 e 9-4.1t4*4 Permit Status: Approved Permit Expiration: 3/15/2003 Construction Value: $51,697.00 Work: RE- TROFIT INTALLATION OF A 70 TON YORKS AIR COOLED CHILLER If there is no permit package accessible on the job -site for inspectors to verify, there will be no inspections. Re- inspection fee is $50.00, which must be paid in advance before calling for another inspection. This Permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statements or specifications and that he assumes responsibility for work done by his agents, servants or employees. Signed: ( 7. X Signed: U" . 1 '•' (INSPECTOR) Mechanical Permit Permit Number: ME2002 -127 Contractor's Address: BY: Page 1 of 1 Legal Description: MIAMI SHORES SEC 2 PB 10 -37 LOTS 1 TO 10 INC BLK 61 LOT SIZE LOC) , . Total Fees: Total Receipts: $0.00 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either anyself, my agent, servants or e •!oyes. (Contractor or Builder) BY: MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 - 795 -2204 Building Inspection Reques Dates 0��6/�LU? Time Type Insp' Permit No. Address d . F. 11j - Company For Inspector: Approved Correction Re- Insp'n Fee Phone #3 OS- � T s 3 y l 3 amA & Date -01. MIAMI SHORES VILLAGE BUILDING DEPARTMENT 305 - 795 -2204 Building Inspection Req Date / Time 111 Type Insp'n 4 f Permit No. y �' 2.- (2 7 Name C�� �(- . , o Address . 452 etic 9e 5/ Compan 6", , - V 1 Phone # ?of— — 2_7 7 R4-( For Inspector: Approved Correction Re- Insp'n Fee s 42:42 Name & Date ga2coel 14.we PAY TO THE ORDER OF MIAMI SHORES PRESBYTERIAN CHURCH 602 NE. 96TH ST. MIAMI SHORES, FL 33138 ONE THOUSAND ELEVEN DOLLARS AND TWENTY CENTS Miami Shores Village 10050 NE Second Av. Miami Shores FL 33138 -2382 For: Mechanical Permit 11 1:0631002771: 00366425 BANK OF AMERICA 02992 FIL 63- 27-631 Gde -y�y .� 7 . DATE AMOUNT 09/30/2002 * * * * ** *1,011.20 **